October 26, 2015

ISASS Signs on to AMA Letter to NAIC

ISASS signed on to an AMA letter to the National Association of Insurance Commissioners (NAIC) regarding updates to the Network Adequacy Model Act. NAIC is the standard-setting and regulatory support organization in the United States created and governed by the chief insurance regulators from the 50 states, Washington D.C. and five U.S. territories. NAIC is currently working to update its 1996 Network Adequacy Model Act which is used as a template to draft/update state statutes that regulate the insurance industry. The letter touches upon three areas of concern and presents corresponding recommendations to strengthen patient protections in the Model Act: 1. require prior approval of networks before health plans are sold; 2. require states to institute measurable quantitative standards for network adequacy; and 3. include stronger protections for tiered networks. Letter to NAIC […]
September 30, 2015

ISASS Policy & Advocacy News – September 2015

News and noteworthy information for September: New FDA Commissioner Nominated FDA Establishes Patient Engagement Advisory Committee on Medical Devices ICD-10 News Medicare Administrative Contractor News Physician Quality Reporting System Payment Adjustment and Informal Review Process Physician Compare Preview Period for Reported Quality Measures AMA Develops Resources for Evaluating and Understanding New Payment Model Commercial Payer Contracts   New FDA Commissioner Nominated On September 15, President Obama nominated Dr. Robert Califf as Commissioner of the Food and Drug Administration (FDA). Margaret Hamburg resigned as FDA Commissioner in March of this year; since that time, Stephen Ostroff, previously the FDA’s chief scientist, has served as Interim Commissioner. Dr. Califf currently serves as the FDA’s Deputy Commissioner for Medical Products and Tobacco, a […]
September 24, 2015

ICD-10 News

On August 31, ISASS staff participated on a National Provider Call hosted by the Centers for Medicare and Medicaid Services (CMS), “Countdown to ICD-10”, where CMS emphasized preparation, assistance and collaboration during the transition to ICD-10. As you already know, ICD-10 codes must be used for services provided on and after October 1, 2015. ISASS compiled relevant information and provided its members with an “ICD-10 Guide for Spine Practices” on August 21, 2015. Since that time, CMS named Dr. William Rogers as its ICD-10 Ombudsman. Dr. Rogers is an emergency room physician, a Clinical Assistant Professor of Emergency Medicine at Georgetown University Hospital, a State Air Surgeon in the US Air Force, and the Director of CMS’ Physician Regulatory Improvement […]
September 22, 2015

ISASS Shares Updated MIS SIJ Fusion Coverage Criteria with Commercial Payers and MACs

Continuing ISASS advocacy efforts on minimally invasive sacroiliac joint fusion (MIS SIJ fusion), ISASS sent a letter to the eight Medicare Administrative Contractors (MACs) and more than 55 commercial health insurance companies to share our updated coverage guidelines on the procedure in an effort to expand patient access and coverage of the surgery. ISASS Letter to Payers